Revenue Cycle Claims Specialist

USA Clinics Group is seeking an experienced and highly detailed Revenue Cycle Claims Specialist to join our Revenue Cycle team! The Revenue Cycle Claims Specialistis the primary source for managing patient’s delinquent accounts including sending patients to collections. This position will hold the responsibility of arranging repayment agreements with the patient and assisting in other parts of the billing office as needed.

Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.

Responsibilities

• Contacts insurance carriers regarding claim status, denials, underpayments, and recoupments
• Be able to read and understand insurance eligibility and benefits
• Research & resolve outstanding claim issues and patterns
• Submit Appeals for Denied Claims
• Submit Medical Records and other documentation requests to insurance
• Ability to work on 40+ denied claims per day on the phone and provider portals
• Performs additional duties as assigned

Requirements

• 2 or more year's previous experience in customer service, call center or medical collections, required
• Ability to read and understand insurance remittance including denial and remark codes required
• Ability to understand the remittance denial codes and get claims reprocessed required
• Experience with Aetna, BCBS, UHC, Medicare, and Medicaid denials preferred
• Experience with multi state insurance denial collecting a plus
• Experience using Excel is a plus
• Experience with denials for Varicose veins, and/or Dialysis is a plus
• Familiar with provider portal eligibility and claim tools. Example: Availity, Navinet, preferred
• Strong personality and willingness to rebuttal with insurance claims representatives to overturn denials
• Exceptional customer service and phone etiquette
• Ability to maintain effective and organized systems
• Ability to communicate effectively both verbally and in writing

Benefits

• Health
• Dental
• Vision
• 401K & Match